Heart Diseases and Respiratory Diseases: Transplant Surgery
The question
To ask the Secretary of State for Health and Social Care, if his Department will assess the adequacy of the provision of heart and lung transplant services, including (a) access to specialist care, (b) post-transplant follow-up services, (c) psychological support for transplant recipients and their families, (d) long-term management of transplant recipients and (e) variation in outcomes between transplant centres.
Answered by Preet Kaur Gill
The Government recognises the importance of ensuring timely and equitable access to heart and lung transplantation services and of improving patient outcomes. This response relates to England only.
Access to transplantation is based on nationally agreed clinical criteria, with donor organs offered, or allocated, through a national system managed by NHS Blood and Transplant (NHSBT) to ensure equity according to clinical need. NHSBT publishes data annually on access and outcomes in its organ-specific reports, with further information available at the following link:
https://www.odt.nhs.uk/statistics-and-reports/annual-activity-report/
This data shows some variation in post-transplant survival rates between centres, but good overall rates. In addition, it shows some geographical variation in lung registration rates and no evidence of variation beyond chance for heart and lung transplantation rates. Further work is needed to understand and address unwarranted variation in access to transplantation.
Variation in patient outcomes, including longer‑term survival and listing outcomes, are reviewed through established NHSBT and NHS England clinical governance processes, including routine outcome reviews and centre‑specific follow‑up where indicated. The National Transplant Clinical Panel has been established to provide expert clinical interpretation of transplant outcome data to support quality oversight, including where issues of statistical variation are identified.
Heart and lung transplant services provide multidisciplinary assessment, ongoing follow‑up, and access to psychological support where clinically indicated, ensuring that care addresses both physical and mental health needs across the patient pathway, before and after transplantation. The quality and effectiveness of care is monitored through national audit, service review, and patient feedback, with oversight provided by the National Transplant Clinical Panel.
To improve equity of access, transplant activity, and outcomes, NHS England has established a national improvement programme, informed by the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise. This programme, alongside NHS England commissioning structures, includes work to improve referral pathways, organ utilisation, and service consistency, through strengthened peer review processes, audit of organ acceptance practices, and work with transplant centres to support consistent decision-making. Further information on the national improvement programme and the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise is available at the following two links:
While progress has been made, including increases in transplant activity and reductions in waiting lists, NHS England continues to work with partners and patients to ensure services are consistent, resilient, and able to meet patient need across the country.
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